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INDONESIA
Jurnal Farmasi Klinik Indonesia
Published by Universitas Padjadjaran
ISSN : 23375701     EISSN : 2337 5701     DOI : -
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Indonesian Journal of Clinical Pharmacy (IJCP) is a scientific publication on all aspect of clinical pharmacy. It published 4 times a year by Clinical Pharmacy Master Program Universitas Padjadjaran to provide a forum for clinicians, pharmacists, and other healthcare professionals to share best practice, encouraging networking and a more collaborative approach in patient care. Indonesian Journal of Clinical Pharmacy is intended to feature quality research articles in clinical pharmacy to become scientific guide in fields related to clinical pharmacy. It is a peer-reviewed journal and publishes original research articles, review articles, case reports, commentaries, and brief research communications on all aspects of Clinical Pharmacy. It is also a media for publicizing meetings and news relating to advances in Clinical Pharmacy in the regions.
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Drug Utilization Evaluation Anti Edema Otak pada Pasien Stroke Hemoragik di Rumah Sakit Bethesda Yogyakarta Viktoria M. Chyntia; Rizaldy T. Pinzon
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.37

Abstract

Strok hemoragik adalah subtipe stroke yang menyebabkan tingginya mortalitas dan morbiditas. Edema otak adalah salah satu kontributor yang menjadi penyebab kematian. Penelitian ini bertujuan untuk mengevaluasi rasionalitas penggunaan anti edema otak pada pasien strok hemoragik di Rumah Sakit Bethesda Yogyakarta serta mengetahui faktor yang berpengaruh terhadap luaran klinis pasien. Penelitian ini merupakan penelitian non-eksperimental analitik dengan rancangan cohort retrospective dan dilaksanakan pada bulan April–Mei 2018 di Rumah Sakit Bethesda Yogyakarta. Subjek penelitian adalah pasien strok hemoragik intraserebral yang memenuhi kriteria inklusi dan diambil menggunakan teknik consecutive sampling. Rasionalitas penggunaan obat dievaluasi berdasarkan Panduan Praktik Klinis Neurologis (Perdossi) 2016, Drug Information Handbook 20th Edition, dan luaran klinis berdasarkan Skala Rankin. Data diolah secara statistik menggunakan uji Chi-Square dan regresi logistik. Hasil penelitian menunjukkan bahwa dari 52 subjek penelitian, subjek laki-laki berjumlah 26 (50,0%) dan subjek perempuan berjumlah 26 (50,0%). Penggunaan anti edema otak rasional pada 43 subjek (82,7%) dan tidak rasional pada 9 subjek (17,3%). Penggunaan obat yang tidak rasional meliputi tidak tepat dosis (11,5%) dan tidak tepat obat (5,8%). Sebanyak 17 subjek (32,7%) yang mendapat terapi rasional luaran klinisnya membaik, sedangkan 26 subjek (50,0%) luaran klinisnya memburuk. Pada subjek yang mendapat terapi tidak rasional, sebanyak 1 subjek (1,9%) luaran klinisnya membaik, sedangkan 8 subjek (5,4%) luaran klinisnya memburuk. Hasil analisis bivariat antara rasionalitas penggunaan anti edema otak dengan luaran klinis menunjukkan tidak terdapat hubungan yang bermakna (p=0,139) dan hasil analisis multivariat menunjukkan multivitamin adalah faktor yang paling mempengaruhi luaran klinis (RR 13,968; IK95% 1,459–133,711; p=0,022).Kata kunci: Anti edema otak, drug utilization evaluation, strok hemoragik Drug Utilization Evaluation of Anti Brain Oedema for Hemorrhagic Stroke Patients in Bethesda Hospital Yogyakarta AbstractHemorrhagic stroke is a subtype of stroke that causes high mortality and morbidity. However, brain oedema is one of the contributors that cause mortality. The purpose of this study was to evaluate the rationality of anti-brain oedema use in  hemorrhagic stroke patients at Bethesda Hospital Yogyakarta and to determine factors that influence a patient’s clinical outcome. The study was a non-experimental method conducted using a cohort retrospective design from April to May 2018 at Bethesda Hospital Yogyakarta. According to the inclusion criteria, subjects were intracerebral hemorrhagic stroke patients and were obtained using a consecutive sampling technique. Furthermore, evaluation of the rational use of anti-brain oedema was based on Panduan Praktik Klinis Neurology (Perdossi) 2016, Drug Information Handbook 20th Edition and ranking scale to assess outcome. Data were statistically processed using the Chi-Square test and logistic regression.  The results showed that of the 52 subjects, 26 were males (50.0%) and 26 females (50.0%); rational use of anti-brain oedema was in 43 subjects (82.7%) while 9 subjects (17.3%) was irrational; irrationality consisted of a wrong dose (11.5%) and wrong medicine (5.8%); about 17 subjects (32.7%) obtaining rational therapy had better outcome while 26 subjects (50.0%) had worse outcome; also 1 subject (1.9%) obtaining irrational therapy had better outcome meanwhile 8 subjects (5.4%) had a worse outcome. However, the result of bivariate analysis showed no significant relationship between rationalities of the use of anti-brain oedema and clinical outcome (p=0.139), and multivariate analysis indicated multivitamin as the most influencing factor to the clinical outcome (RR 13.968; 95%CI 1.459–133.711; p=0.022).Keywords: Anti brain oedema, drug utilization evaluation, hemorrhagic stroke
Kejadian Demam Neutropenia pada Pasien Kanker Payudara setelah Menerima Regimen Kemoterapi TAC-G-CSF dan FAC di RSUP Dr. Hasan Sadikin Bandung Nusaibah A. Hima; Retnosari Andrajati; Maksum Radji
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.1

Abstract

Demam neutropenia merupakan efek samping yang sering terjadi setelah kemoterapi. Demam neutropenia dapat menyebabkan penundaan dosis kemoterapi sehingga dapat mengurangi efektivitas terapi. Kejadian demam neutropenia setelah kemoterapi dapat dicegah dengan pemberian Granulocyte-colony Stimulating Factor (G-CSF). Regimen kemoterapi yang digunakan dapat memengaruhi kejadian demam neutropenia. Selain itu, usia, stadium kanker, riwayat kemoterapi dan kadar hemoglobin sebelum kemoterapi merupakan faktor risiko demam neutropenia setelah kemoterapi. Penelitian ini bertujuan untuk mengetahui perbandingan kejadian demam neutropenia regimen Dosetaksel, Doksorubisin, Siklofosfamid (TAC) dengan profilaksis primer G-CSF dan regimen Fluorourasil, Doksorubisin, Siklofosfamid (FAC) pada pasien kanker payudara di RSUP Dr. Hasan Sadikin Bandung periode Januari 2017–Juni 2019. Desain penelitian adalah cross sectional uji dua populasi. Jumlah sampel sebanyak 61 regimen TAC-G-CSF dan 102 regimen FAC. Kejadian demam neutropenia dianalisis menggunakan Chi-Square, Kruskal Wallis dan regresi logistik. Hasil penelitian menunjukkan kejadian demam neutropenia setelah kemoterapi pada regimen TAC dengan profilaksis primer G-CSF lebih tinggi dibanding pada regimen FAC. Usia, stadium kemoterapi, riwayat kemoterapi dan kadar hemoglobin sebelum kemoterapi secara statistik tidak signifikan memengaruhi kejadian demam neutropenia setelah kemoterapi.Kata kunci: Demam neutropenia, FAC, granulocyte-colony stimulating factor (G-CSF), regimen kemoterapi, TAC  The Incidence of Febrile Neutropenia in Patients with Breast Cancer after Receiving TAC-G-CSF and FAC Chemotherapy Regimen at Dr. Hasan Sadikin Hospital Bandung AbstractFebrile neutropenia is a common side effect of chemotherapy, and it reduces the effectiveness of therapy through the delay in chemo doses. Granulocyte-colony Stimulating Factor (G-CSF) is administered to prevent its incidence. The chemotherapy regimen affects the incidence of febrile neutropenia. Risk factors for febrile neutropenia include; age, stage of cancer, history of chemotherapy and pre-chemotherapy hemoglobin level. The purpose of this study was to compare the incidence of febrile neutropenia between Docetaxel, Doxorubicin, Cyclophosphamide (TAC) regimen with G-CSF primary prophylaxis and Fluorouracil, Doxorubicin, Cyclophosphamide (FAC) regimen in patients with breast cancer at Dr. Hasan Sadikin Hospital Bandung at the period of January 2017–June 2019. The cross-sectional study design of two populations was used. The sample consisted of 61 TAC and 102 FAC regimens. The Chi-Square, Kruskal Wallis, and logistic regression were used to analyze the incidence of febrile neutropenia. The results showed that the incidence of post-chemotherapy febrile neutropenia in TAC regimen with G-CSF primary prophylaxis was higher compared with FAC regimen. Furthermore, the risk factors had no statistical influence on the incidence of febrile neutropenia. Keywords: Chemotherapy regimen, FAC, febrile neutropenia, granulocyte-colony stimulating factor (G-CSF), TAC
Perbandingan Self-Report dengan Caregiver-Report mengenai Health-Related Quality of Life Anak dengan Talasemia Mayor Usia 8-12 Tahun Putu G. P. R. Mudita; Fredrick D. Purba; Aulia Iskandarsyah
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.50

Abstract

Penyakit kronis seperti talasemia telah diketahui memengaruhi kualitas hidup terkait kesehatan anak-anak. Jika anak belum mampu menilai kondisi kesehatannya sendiri, penilaian biasanya dilakukan oleh caregiver, terutama orang tua. Hanya saja, beberapa penelitian tidak menyarankan menggunakan laporan dari caregiver mengenai anak karena caregiver (terutama orang tua) cenderung menilai lebih tinggi atau lebih rendah kualitas hidup anaknya sehingga hasil penilaian berisiko tidak akurat dalam menggambarkan kualitas hidup anak yang sebenarnya. Penelitian ini bertujuan untuk membandingkan penilaian anak itu sendiri (self-report) dengan penilaian caregiver (caregiver-report) mengenai kualitas hidup terkait kesehatan anak dengan talasemia mayor. Penelitian dilakukan di Klinik Hemato Onkologi Anak RSUP Dr. Hasan Sadikin Bandung pada bulan April 2019. Sebanyak 50 pasien anak dengan talasemia mayor beserta caregiver-nya yang memenuhi kriteria mengisi kuesioner Pediatrics Quality of Life Inventory (PedsQL) 4.0. Ada empat dimensi yang diukur, yaitu fungsi fisik, emosional, sosial, dan sekolah. Perbandingan kualitas hidup terkait kesehatan antara self-report dengan caregiver-report menggunakan uji Wilcoxon Signed Ranks Test. Hasil yang diperoleh adalah tidak terdapat perbedaan yang signifikan pada skor total antara self-report dengan caregiver-report mengenai kualitas hidup terkait kesehatan anak dengan talasemia mayor usia 8–12 tahun (p=0,952), begitu pula pada skor kesehatan fisik (p=0,258), fungsi emosional (p=0,086), dan fungsi sekolah (p=0,470). Perbedaan signifikan hanya terdapat pada fungsi sosial (p=0,046), dengan skor rata-rata self-report lebih rendah dibandingkan caregiver-report. Hal ini menunjukkan bahwa pada kasus-kasus pasien anak tidak dapat mengisi sendiri, orang tua adalah penilai atas nama anak (proxy) yang cukup dapat diandalkan untuk menentukan kualitas hidup terkait kesehatan anak. Kata kunci: Anak-anak, kualitas hidup terkait kesehatan, PedsQL, talasemia mayor Comparison of Self-Report and Caregiver-Report Regarding Health-Related Quality of Life in Children with Major Thalassemia Aged 8–12 Years AbstractThalassemia is a chronic illness known for influencing children’s health-related quality of life (HRQOL). The assessment of a child’s condition is usually carried out by their caregiver, especially parents when the child is unable to assess their health condition. However, some studies do not recommend using caregiver-report because caregivers (especially parents) tend to rate higher or lower on their child’s quality of life. Therefore, the results are at risk of being inaccurate in describing the child’s actual quality of life. The purpose of this study was to compare the child’s own assessment (self-report) with the caregiver’s assessment (caregiver-report) of HRQOL for children with major thalassemia. Furthermore, the study was conducted at the Pediatric Hemato Oncology Clinic Dr. Hasan Sadikin Hospital Bandung in April 2019. The Pediatrics Quality of Life Inventory (PedsQL) 4.0 was completed by a total of 50 pediatric patients with major thalassemia together with their caregivers. Also, four dimensions measured include; physical, emotional, social, and school functioning. Wilcoxon Signed Ranks test was used to compare HRQOL between self-report and caregiver-report. The result showed that there was no significant difference in total score between self-report and caregiver-report regarding HRQOL of children with major thalassemia ages 8–12 years p=0.952), as well as physical functioning (p=0.258), emotional functioning (p=0.086), and school functioning (p=0.470). However, a significant difference was only found in social functioning (p=0.046), where the average score of self-report was lower than the caregiver-report. Subsequently, this shows that in cases where the children are unable to complete the questionnaire themselves, parents are a reliable rater on behalf of the child (proxy) to determine the quality of life of the children.Keywords: Children, health-related quality of life, major thalassemia, PedsQL 
Analisis Efektivitas-Biaya Terapi Kombinasi Metformin-Insulin dan Metformin-Sulfonilurea pada Pasien Rawat Jalan dengan Diabetes Melitus Tipe 2 di RSUPN Dr. Cipto Mangunkusumo Fitriyani Fitriyani; Retnosari Andrajati; Yulia Trisna
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.10

Abstract

Diabetes melitus tipe 2 (DMT2) diketahui sebagai salah satu masalah kesehatan yang memberikan beban ekonomi yang cukup besar pada sistem pelayanan kesehatan di seluruh dunia. Bervariasinya penggunaan terapi obat akan mengakibatkan adanya perbedaan dalam efektivitas dan biaya terapi, sehingga perlu dilakukan analisis efektivitas-biaya. Tujuan dari penelitian ini adalah menganalisis efektivitas-biaya terapi kombinasi metformin-insulin (Met-Ins) dan metformin-sulfonilurea (Met-SU) pada pasien rawat jalan dengan DMT2 berdasarkan perspektif rumah sakit. Penelitian ini menggunakan desain studi kohort, pengambilan data dilakukan secara retrospektif di RSUPN Dr. Cipto Mangunkusumo menggunakan rekam medik pasien rawat jalan dengan DMT2 dan data billing rumah sakit pada periode Januari 2016–Juni 2019. Dilakukan perbandingan efektivitas terapi (∆HbA1c) dan biaya medis langsung antara kedua kelompok. Hasil analisis menunjukkan ∆HbA1c antara kelompok Met-Ins dan kelompok Met-SU tidak memiliki perbedaan yang bermakna secara statistik (rata-rata perbedaan 0,123%; p=0,608). Median biaya medis langsung kelompok Met-Ins lebih tinggi dibandingkan kelompok Met-SU (p<0,001). Hasil analisis efektivitas-biaya menunjukkan bahwa terapi kombinasi Met-SU lebih cost-effective dibandingkan kombinasi Met-Ins.Kata kunci: Analisis efektivitas-biaya, diabetes melitus tipe 2, insulin, metformin, sulfonilurea  Cost-Effectiveness Analysis of Metformin-Insulin and Metformin-Sulfonylurea Combination Therapy in Outpatients with Type 2 Diabetes Mellitus at Dr. Cipto Mangunkusumo Hospital AbstractType 2 diabetes mellitus (T2DM) is a health problem that impose economic costs on the health care systems globally. Consequently, variation of drug therapy leads to differences in the effectiveness and cost of therapy, therefore cost-effectiveness analysis is of importance. The purpose of this study was to analyze the cost-effectiveness of metformin-insulin (Met-Ins) and metformin-sulfonylurea (Met-SU) combination therapy in outpatients with T2DM based on the hospital perspective. A retrospective cohort study was conducted at Dr. Cipto Mangunkusumo Hospital using medical records of outpatients with T2DM and hospital billing between January 2016–June 2019. The effectiveness of the therapy (∆HbA1c) and direct medical costs between the two groups was compared. The analysis showed that ∆HbA1c between the Met-Ins group and the Met-SU group had no statistically significant differences (mean difference 0,123%; p=0.608). Meanwhile, the median of direct medical costs of the Met-Ins group was higher than the Met-SU group (p<0.001). The results of the analysis showed that the combination therapy of Met-SU was more cost-effective compared to that of Met-Ins.Keywords: Cost-effectiveness analysis, insulin, metformin, sulfonylurea, type 2 diabetes mellitus 
Artikel Review: Interaksi Silang Pensinyalan WNT dan TGF-β pada Kanker Paru dengan MikroRNA sebagai Mayoritas Regulator Nita Rahmasari; Melisa I. Barliana; Riezki Amalia
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.62

Abstract

Posisi pertama untuk kejadian dan mortalitas kanker paru di dunia saat ini masih menjadi tantangan untuk menemukan dan mengembangkan terapi potensial bagi pasien kanker paru. Pemahaman pada tingkat molekular mengenai progres tumor pada kanker sangat diperlukan untuk menemukan rejimen terapi yang efektif; terdapat perubahan genetik pada berbagai jalur pensinyalan pengatur proses biologi yang terlibat selama karsinogenesis. Pensinyalan WNT dan TGF-β telah banyak diidentifikasi pada beberapa penelitian, khususnya mengenai interaksi keduanya dalam tumorigenesis paru, namun belum cukup diulas secara jelas. Oleh karena itu, dilakukan pengkajian terhadap 10 artikel riset yang diakses secara online melalui database MeSH PubMed dengan kata kunci “Receptors, Wnt/Wnt Signaling Pathway/Wnt Proteins” AND “Receptors, Transforming Growth Factor beta/Transforming Growth Factor beta” AND “Lung Neoplasms/Small Cell Lung Carcinoma/Carcinoma, Non-Small-Cell Lung”, untuk menyusun ulasan mengenai interaksi silang keduanya pada kanker paru secara lebih jelas. Secara menyeluruh, interaksi silang antara pensinyalan WNT dan TGF-β meregulasi pemrograman Cancer Stem Cell (CSC) dan Epithelial–Mesenchymal Transition (EMT) selama tumorigenesis dan prognosis kanker paru yang berdampak pada metastasis, peningkatan agresivitas, serta kemoresistensi tumor. Interaksi silang pensinyalan WNT dan TGF-β pada kanker paru dapat terjadi secara langsung pada tingkat kompleks transkripsi mereka ataupun dengan melibatkan suatu mediator penting, yang sebagian besarnya diperankan oleh mikroRNA. Terdapat berberapa mikroRNA yang telah teridentifikasi baik pada kanker paru dalam meregulasi interaksi silang antara pensinyalan WNT dan TGF-β, seperti miR-1827, miR-3127-5p, dan miR-128-3p. Pembahasan ini mengimplikasikan peluang yang tinggi pada penekanan kedua jalur WNT dan TGF-β secara simultan dan efektif dengan menargetkan suatu molekul yang berpotensi untuk kanker paru.Kata kunci: Interaksi silang pensinyalan, kanker paru, pensinyalan TGF-β, pensinyalan WNT  Review Article: Crosstalk between WNT and TGF-β signaling in Lung Cancer with MicroRNA as Majority of RegulatorsAbstractThe discovery and development of potential therapies to reduce the incidence and mortality of lung cancer is still a challenge. Consequently, identifying an effective therapeutic regimen is necessary for tumor progression in cancer at the molecular level due to genetic changes in various signaling pathways that regulate the biological processes involved during carcinogenesis. WNT and TGF-β signaling have been widely identified in several studies, with regards to the interaction of both in pulmonary tumorigenesis although they have not been adequately reviewed clearly. Hence, an assessment of 10 research articles was conducted online through the MeSH PubMed database with the keywords “Receptors, Wnt/Wnt Signaling Pathway/Wnt Proteins” AND “Receptors, Transforming Growth Factor beta/Transforming Growth Factor beta” AND “Lung Neoplasms/Small Cell Lung Carcinoma/Carcinoma, Non-Small-Cell Lung”, to compile an overview of the crosstalk. Furthermore, the crosstalk between WNT and TGF-β signaling regulates the programming of Cancer Stem Cell (CSC) and Epithelial–Mesenchymal Transition (EMT) during tumorigenesis and prognosis of lung cancer that leads to metastasis, increased aggressiveness, and tumor chemoresistance. The crosstalk of WNT and TGF-β signaling in lung cancer can occur directly at the level of their transcription complex or by involving an important mediator, most of which is played by microRNA. There are several microRNAs identified in regulating crosstalk between WNT signaling and TGF-β, such as miR-1827, miR-3127-5p, and miR-128-3p. The discussion implies a high opportunity for the simultaneous and effective suppression of both WNT and TGF-β pathways by targeting a molecule that has the potential for lung cancer.Keywords: Lung cancer, signaling crosstalk, TGF-β signaling, WNT signaling
Analisis Tarif INA-CBGs Pasien Hipertensi Rawat Inap di Rumah Sakit Umum Daerah Panembahan Senopati Anis F. Nilansari; Nanang M. Yasin; Diah A. Puspandari
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.22

Abstract

Angka pengidap hipertensi pada tahun 2018 sebesar 34,1% dari penduduk Indonesia. Profil data kesehatan Indonesia menyebutkan bahwa secara nasional terjadi peningkatan prevalensi hipertensi dari 25,8% pada tahun 2013 menjadi 34,1% pada tahun 2017. Biaya pasien hipertensi rawat inap di rumah sakit yang bergabung dengan Asuransi Kesehatan JKN diklaim berdasarkan tarif Indonesian-Case Based Groups (INA-CBGs). Penelitian ini bertujuan untuk mengetahui besar perbedaan biaya riil rumah sakit dengan tarif INA-CBGs di Rumah Sakit Umum Daerah (RSUD) Panembahan Senopati menggunakan analisis deskriptif pada perspektif penyedia pelayanan kesehatan yaitu rumah sakit. Pengambilan data biaya medis langsung dilakukan secara retrospektif. Objek pada penelitian ini adalah berkas keuangan rumah sakit dan rekam medis periode Oktober 2016–Juli 2017 RSUD Panembahan Senopati. Sebanyak 53 pasien menjadi sampel penelitian ini. Data dianalisis menggunakan one sample t-test untuk membandingkan biaya riil rumah sakit dengan tarif INA-CBGs. Hasil penelitian menunjukkan besarnya perbedaan antara biaya riil dengan tarif INA-CBGs yaitu sebesar negatif Rp30.993.964. Terdapat perbedaan bermakna antara besar biaya riil yang dikeluarkan rumah sakit terhadap tarif INA-CBGs pada pasien kelas 1 dengan nilai signifikansi p<0,05 (0,039). Persentase total biaya rumah sakit yang digunakan untuk komponen biaya obat yaitu sebesar 26,3%. Simpulan dari penelitian ini adalah rumah sakit dapat mengalami kerugian karena biaya yang dikeluarkan lebih besar dibandingkan tarif klaim INA-CBGs.Kata kunci: Biaya pasien, hipertensi, INA-CBGs, JKN, rumah sakit Analysis of INA-CBGs Rates of Hypertensive Inpatients in Panembahan Senopati Hospital AbstractThe number of people with hypertension reached 34.1% of the Indonesian population in 2018. According to the Indonesian health profile data, an increase from 25.8% in 2013 to 34.1% in 2017 in the prevalence of hypertension nationally was observed. The costs of hypertensive inpatients in hospitals joining the JKN Health Insurance were claimed based on Indonesian-Case Based Groups (INA-CBGs) rates. The purpose of this study is to determine the difference between real costs of hospitals and INA-CBGs rates in Panembahan Senopati Hospital. A descriptive analysis based on the perspective of health care providers was conducted and retrieval of medical costs data was done directly. The hospital financial sheets and medical records between October 2016–July 2017 were used as objects of this study. Furthermore, the samples of this study included a total of 53 patients and analysis of data was achieved using the one sample t-test to compare real hospital costs with INA-CBG rates. The results showed a large difference between the real cost and INA-CBG rates, which was negative Rp30,993,964. There was a significant difference between hospital’s real costs incurred by hospitals and the INA-CBG rates for grade 1 patients with a significant value of p<0.05 (0.039). The percentage of total hospital costs used for the component costs of drugs was 26.3%. This study concludes that hospitals can suffer losses because the costs incurred are more significant than the INA-CBGs claim rates.Keywords: Hospitals, hypertension, INA-CBGs, JKN, patients cost
Studi Pola Pemberian Artemisinin-Based Combination Therapy pada Pasien Malaria di RSUD Supiori Papua Sandra J. Parambang; Didik Hasmono; Jenggo Suwarko
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.30

Abstract

Malaria merupakan salah satu penyakit dengan prevalensi tinggi di Indonesia. Data Riset Kesehatan Dasar (Riskesdas) tahun 2018 menunjukkan prevalensi populasi malaria berdasarkan riwayat pemeriksaan darah tertinggi di Indonesia pada tahun 2013–2018 yaitu di Provinsi Papua. Tujuan penelitian adalah mengetahui pola pemberian dan ketepatan terapi Artemisinin based combination therapy (ACT) di RSUD Supiori, Papua. Penelitian ini merupakan penelitian deskriptif dengan pengambilan data secara retrospektif yaitu melakukan penelusuran terapi melalui rekam medis pasien dan dokumen pencatatan yang lain. Penelitian dilakukan pada periode Januari–Agustus 2019 terhadap 1.636 orang dan 71 pasien dinyatakan positif malaria. Seluruh pasien (100%) diterapi dengan Dyhidroartemisinin-piperaquin (DHP). Kasus malaria falciparum ditemukan pada 33 orang (46,48%), dan hampir seluruhnya (96,97%) diterapi dengan DHP+Primakuin. Kasus malaria vivax ditemukan pada 33 orang (46,48%), yang seluruhnya (100%) diterapi dengan DHP+Primakuin. Kasus malaria mix ditemukan pada 5 orang (7,04%), sebanyak 4 orang (80,00%) diterapi dengan DHP+Primakuin dan 1 orang (20,00%) diterapi dengan Artesunate dilanjutkan dengan DHP+Primakuin.Pola pemberian terapi malaria di RSUD Supiori pada periode Januari–Agustus 2019 telah sesuai pedoman tatalaksana malaria. Kata kunci: Artemisinin-based combination therapy (ACT), malaria, pola pemberian terapi  Study of Artemisinin-Based Combination Therapy Patterns in Malaria Patients at Supiori Hospital, Papua AbstractMalaria is a disease with high prevalence in Indonesia. According to the Basic Health Research data (Riskesdas) 2018, the province with the highest prevalence of malaria based on the results of blood tests in Indonesia was Papua. The research aims to determine the accuracy of Artemisinin-based combination therapy (ACT) pattern at Supiori Hospital, Papua. Furthermore, a descriptive study and data collection were conducted retrospectively by tracking the treatment history recorded in the patient medical records and other documents. The study was conducted between January–August 2019 and out of 1.636 patients, 71 tested positive for malaria. All patients (100%) were treated with Dyhidroartemisinin-piperaquine (DHP). Falciparum malaria cases were found in 33 people (46.48%), and almost all (96.97%) were treated with DHP+Primaquine. Vivax malaria cases were found in 33 people (46.48%), all of whom (100%) were treated with DHP+Primaquine. Also, mixed malaria cases were found in 5 people (7.04%), 4 people (80.00%) were treated with DHP+Primaquine and 1 person (20.00%) was treated with Artesunate followed by DHP+Primaquine. Furthermore, the pattern of providing malaria therapy at Supiori Hospital in the period January to August 2019 followed the malaria guidelines.Keywords: Artemisinin-based combination therapy (ACT), malaria, pattern of therapy
Atypical Antipsychotic Induced Weight Gain in Schizophrenic Patients Tetie Herlina; Dyah A. Perwitasari; Haafizah Dania; Santi Yuliani; Melisa I. Barliana
Indonesian Journal of Clinical Pharmacy Vol 10, No 1 (2021)
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15416/ijcp.2021.10.1.57

Abstract

Atypical antipsychotics are widely prescribed and have the potential to cause weight gain, which may result in the development of metabolic syndrome. Also, it is important to monitor the use of atypical antipsychotic for metabolic disturbance. The purpose of this study is to determine the side effects of atypical antipsychotics in increasing body weight in schizophrenia patients after 4 weeks of use. Furthermore, a retrospective design was conducted and data were collected based on consecutive sampling in 80 adult psychiatric inpatients (20 women and 60 men) with initial diagnoses of schizophrenia and with the same daily nutrition. The patients were hospitalized from January to March 2019, within the term (over 4 weeks) of initiation atypical antipsychotic. The patient body weight was collected before and 4 weeks after the treatment of atypical antipsychotic. The results showed that patients (20 women and 60 men) receiving atypical antipsychotic had a mean age of 35.6 years and a percentage of 70% women and 56% men had a weight gain of 1–5 kg over 4 weeks. The mean weight observed among our subjects increased from 57.55±10.743 kg to 59.83±12.205 kg after initiating treatment (p=0.001). However, the dual combination of atypical antipsychotics risperidone and clozapine are the most widely atypical antipsychotic used with a percentage equal to 91.25%, 3.75% clozapine, and 5% risperidone. Furthermore, it can be concluded that atypical antipsychotics use for at least 4 weeks can cause weight gain in schizophrenic patients. Pharmacist and doctors are recommended to monitor the metabolic side effects due to the atypical antipsychotic use. Keywords: Atypical antipsycotic, schizophrenia, weight gain  Antipsikotik Atipikal Menginduksi Peningkatan Berat Badan pada Pasien Skizofrenia AbstrakAntipsikotik atipikal banyak diresepkan dan berpotensi menyebabkan kenaikan berat badan yang dapat menyebabkan sindrom metabolik. Ada kebutuhan klinis yang mendesak untuk memantau penggunaan antipsikotik atipikal terhadap gangguan metabolisme. Penelitian ini bertujuan untuk mengetahui efek samping antipsikotik atipikal dalam meningkatkan berat badan pada pasien skizofrenia setelah pemakaian 4 minggu. Melalui desain retrospektif, data dikumpulkan dengan consecutive sampling pada 80 pasien rawat inap psikiatri dewasa (20 wanita dan 60 pria) dengan diagnosis awal skizofrenia dan dengan pengaturan nutrisi harian yang sama. Pasien dirawat di rumah sakit sejak Januari 2019 sampai dengan Maret 2019, dalam jangka menengah (lebih dari 4 minggu) pemberian antipsikotik atipikal. Data berat badan pasien dicatat sebelum dan 4 minggu sesudah pemakaian antipsikotik atipikal. Pasien (20 wanita dan 60 pria) yang menerima antipsikotik atipikal memiliki usia rata-rata 35,6 tahun, semua pasien dengan persentase 70% wanita dan 56% pria memiliki kenaikan berat badan 1–5 kg selama periode 4 minggu. Berat rata-rata yang diamati di antara subyek meningkat dari 57,55±10,743 kg menjadi 59,83±12,205 kg setelah memulai pengobatan (p=0,001). Antipsikotik atipikal yang paling banyak digunakan adalah kombinasi antipsikotik atipikal risperidon clozapin dengan persentase sebesar 91,25%, clozapin 3,75%, risperidon 5%. Kami menyimpulkan bahwa penggunaan antipsikotik atipikal selama setidaknya 4 minggu dapat menyebabkan penambahan berat badan pada pasien skizofrenia. Apoteker dan dokter direkomendasikan untuk memantau efek samping metabolik akibat penggunaan antipsikotik atipikal.Kata kunci: Antipsikotik atipikal, peningkatan berat badan, skizofrenia

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